HIV and ID Observations

October 29th, 2017

Cellulitis, Lyme, VZV, MRSA, TB, Tdap: Great Questions from ID in Primary Care

We’ve just finished our annual course Infectious Diseases in Primary Care, and once again our attendees — all busy clinicians — asked some excellent questions. Below, a small sample: What is the drug of choice for cellulitis in outpatients who are allergic to penicillin? Importantly, this is about cellulitis — not abscesses — which means most are […]

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January 8th, 2017

Poll: Should Medicine and Family Practice Residency Programs Have a Dedicated HIV Track?

A few medicine and family practice residency programs around the country have a dedicated track that focuses on HIV care. Though the programs naturally differ somewhat in structure — here are two examples from University of Washington and Yale — they generally involve placing the resident into an HIV clinic for their longitudinal outpatient experience. We don’t have […]

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November 20th, 2011

Who Should Care For The Aging HIV Patient? Everything Old is … Oh You Know

Over in Journal Watch AIDS Clinical Care, Carlos Del Rio reviews a couple of remarkable studies on HIV and aging. From one of them: Compared with the controls, the HIV-infected patients had a higher prevalence of renal failure, bone fracture, and diabetes in every age range evaluated, as well as a higher prevalence of cardiovascular disease and […]

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September 4th, 2009

For Suspected H1N1, Get Out the N95 Masks?

So says the Institute of Medicine’s recommendations for protection of health care workers: Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators … Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance with […]

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August 5th, 2009

Just Out: Primary Care HIV Guidelines

Over on the CID web site, they have the revised version of the “IDSA Primary Care Guidelines for the Management of Persons Infected with Human Immunodeficiency Virus”. It’s a great document, filled with useful references and a particularly strong table where to find other consensus guidelines (diabetes, hyperlipidemia, mental health, others). My vote for what will […]

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May 13th, 2009

Working While Contagious: Why Do We Do This?

File this under, “physicians behaving badly”:  The nearly universal MD practice of going to work while sick. The ironic thing is we think we’re being selfless — after all, if we don’t show up, our patients will need to be rescheduled, or someone will need to cover, or some administrative/teaching task will not get done — […]

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April 26th, 2009

Swine Flu Curbsides: Anthrax, SARS Redux?

In my email in-box yesterday AM from a primary care doc: A patient of mine, 40 year old woman totally healthy, is going to Cancun on Tuesday for a conference.  She’ll be there for 6 days. I know there are no cases of swine flu in Cancun yet, and the situation is evolving, but here’s my question:  […]

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February 26th, 2009

Meningococcal Resistance to Ciprofloxacin

Ciprofloxacin-resistant Neisseria meningitidis has now been documented in the United States. Here’s a nice summary in Journal Watch, with two different perspectives. I suppose we shouldn’t be surprised, but it did take a while.  (At least compared to that other famous neisseria-bug, Neisseria gonorrhoeae.) Oh well. Why is this important?  As every practicing ID doc/primary care provider/public health […]

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October 15th, 2008

Back to School, Day 1

We offer two post-graduate courses each year, one entitled Infectious Diseases in Primary Care, and the other AIDS Medicine:  An Intensive Case-Based Course.  The Primary Care one started today, the AIDS course starts on Monday. (Both are equally fascinating.  I am entirely unbiased.) What is so striking is that the participants — and content — barely overlap […]

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